Rheumatoid Arthritis

Rheumatoid arthritis is the most common inflammatory joint disease. The disease is an autoimmune disease which can affect a number of joints in the body. The underlying mechanism causes the immune system to attack tissue in the joints.

The disease can affect people of any age. In the case of children, it is known as juvenile idiopathic arthritis. It often affects men over the age of 60 and women over the age of 50. Women are three times as likely as men to get the disease.


The exact causes of rheumatoid arthritis remain unclear to this day. According to experts, it is highly likely that the chronic disease is caused by genetic factors. Viruses and bacteria are also thought to be possible causes. However, there is a lack of convincing scientific proof.

Environmental influences, on the other hand, have been proven to play a role. Toxic substances at work, smoking and obesity all significantly increase the risk of disease. In addition, rheumatoid arthritis often affects smokers more seriously than non-smokers.




Patients often experience flare-ups, when symptoms become worse, and typical first symptoms of the disease can vary in severity. Initial symptoms include pain in finger and toe joints, fatigue, disrupted sleep, fever, nightly sweats and weight loss.

As the disease progresses, other symptoms may arise:
- swelling of joints, predominantly in arms and legs (rarely large joints such as shoulder joints)

- general lack of energy
- morning stiffness in joints (lasting longer than 30 min)
- joint pain when resting
- rheumatoid nodules on the fingers or underarms
-bursitis, i.e. inflammation of the bursa

As rheumatoid arthritis progresses, cartilage and bones in the affected joints may become damaged or eventually destroyed completely. Other organs such as blood vessels, pleura, eyes, nerves, lungs and heart may also be affected. Early treatment can prevent the disease from progressing further, however.


As part of the DZI and a leader in the field of inflammatory rheumatoid diseases, the Department of Medicine 3 – Rheumatology and Immunology at Universitätsklinikum Erlangen offers efficient and modern diagnosis and treatment options for prognosis, early detection and prevention. The DZI pools expertise from various specialist areas, and patients benefit greatly from this valuable interdisciplinary collaboration.

Significant advances have been made in the treatment of rheumatoid arthritis in recent years. Doctors now have recourse to a number of immunotherapeutical drugs. These drugs intervene in the patient’s immune system and slow down the degeneration of the joints. In the best case scenario, they prevent degeneration altogether, repress symptoms and halt the disease as far as possible.

Immunotherapy treatment is usually based on the drug methotrexate. As it can take some time for the medication to take effect, methotrexate is often given in combination with steroids such as prednisolone. If the inflammation has not subsided entirely or at least substantially after a period of approximately six months, doctors may consider trying other drugs. Traditional disease-modifying drugs (DMARDs) and biopharmaceuticals have an important role to play. These protein-based substances are produced using biotechnological methods and are administered as an injection or intravenously. Biopharmaceuticals either attack the diseased immune cells directly or interfere with certain inflammatory messenger substances in the organism. They act to block the messenger substances outside the cells.

Since 2017, a new group of basic medicines has been available for treating rheumatoid arthritis using immunotherapy, known as Janus kinase inhibitors. They can be taken in tablet form and block a signal pathway within the immune cell, thereby preventing the formation of inflammatory messenger substances.

Patients may also have the opportunity to take part in clinical studies investigating the effectiveness of new drugs or combinations of different active ingredients. The results from studies such as these help medical experts investigate potential new options for treatment and improve existing methods.

Do you have any questions on the treatment of rheumatoid arthritis? Please feel free to get in touch with us by phone, e-mail or via our contact form.